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�� <br />CITY OF <br />everett <br />259-8745 <br />I'*JNSTRl1CTION <br />PEI��IIIT <br />PERMIT NQ:: � � � J � <br />❑ DEMOLITION ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MRILNDORE55 CITY 21P IMONE <br />ARCO 515 S. Flower St. Los Angeles CA 9G�9��- 9(�'�'( <br />ARCHITECTORDESIGNER MAILRDDPESS CITY IP PHONE <br />Barghausen 6625 S. 190th St. #102 I(!t Kent 98032 872-5522 <br />GENERALCONTRAJIOP MAILAD�RESS GITV ZIP PNONE LICENSE� <br />owner <br />MECHANICRLCONTPACTOR MAIL40DRESS CITY 21P PMONE IICENSE� <br />PLUMBING CONTRRCTOR MFIL AOOBESS CITV 21P PMONE LICENSE • <br />CLA55 OF NONN <br />C$ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIH ❑ DEMOLITION I] BUILDING NELOCATION <br />VALUAiION OF WORN <br />5 26n,�o_nn <br />DESCRIBE WORK <br />n lt nPw Aj.�PM M' M f <br />HEhT50URCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />OR <br />�OT � OLOCK 1� <br />220 Si Everett Mall <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM <br />WATER Cl.OSET �TOILET) <br />BATHTUB <br />IAVATORV�WA5HBA51N� <br />SHOWER <br />NITCHEN SINK 6 OISP. <br />DISHWASHER <br />LAUNORYTRAY <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS — RAINL'cAOERS <br />SINK �SERVICE — BAR. ETC.) <br />N/A <br />USE20NE <br />C�2 <br />TYPE OF CONST <br />V-N <br />SREOFBIDG <br />2978 + 1760 <br />FIRE SPRINKLERS FEOL <br />�PPLIC�TIONRCC OY <br />ni. ri <br />SUB �OTAL S <br />PERMIT S <br />TOTALFEE S <br />1RSETUACR SiOE! <br />N/A 25' <br />LOT AREA <br />9�152� <br />OCCUPRNCYGROUF <br />B-2 <br />NO OF STORIES <br />1 <br />) ❑ vE5 Z�CNO <br />PLANS CMELNEO DY <br />I HEREBY CEfiTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATUREOFCONTRACTOR.AUTMOR12EDAGENT.OROWNER DATE <br />X -�%G�c..66 6—�z—e97 <br />TVPE OF EQUIPME <br />A/C — A/HNDLG UNITS — HP. <br />REFRIGERATIO?7 UNITS — HP. EA. <br />901LER5 — B.TL./HP. <br />GAS FIRED A.C. UNITS — B.T.U. <br />FOFCE�AIRSVSTEMS—B.T.U. MEA. <br />WALL HEATERS — B T.U. M <br />UNITHEATERS—B7.0 M <br />EVAPORATIVE COOLERS <br />CLOTHESDFYERS <br />VENTILATION FAN <br />RANG�HUOD <br />WATERHEATER • <br />WOODSTOVE <br />METAL FIREPLACE 8 CMIMNEY <br />FIREPLACEINSERT <br />MEAT PUMP <br />GAS PIPING <br />E%HAUSTFAN <br />YES ❑ NO <br />roFowe�uNcur+irs BUILDING <br />0 PLUMBING <br />B.E. � L.C. <br />ov <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />FEE <br />� <br />MECHANICAL I �= ��'L�I 5 <br />INVESTIGATION FEE <br />STATE BUILDING SURCHARG <br />STATEENGRGVSURCHARGE <br />DtiIVEWAV PERMIT PAZD <br />TOTAL <br />L�.'�1?I 4�Ly4.�,67. <br />',-ri.T �F. :SU��� . l)l) <br />FEE <br />HQ�ZA I 00 <br />PENMIT VALIDATION <br />WHEN PROPCRLY VALIDATEO pN THIS SPACE) THIS IS YOUR PEFMIT <br />S%d(MK Signage to be under seperate permit. <br />Si[�6IC Separate plumhing & Mechanical permits=to be obtained by respective X <br />contractor. <br />AGOFE<S � ILE <br />